| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 8888888 |
Internal/system code - not a standard HCPCS code |
138,556 |
54,466 |
$94.23M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
46,992 |
42,159 |
$3.74M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,477 |
3,171 |
$2.42M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
8,890 |
8,154 |
$1.80M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
25,087 |
22,936 |
$1.68M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
23,756 |
18,143 |
$1.63M |
| 85027 |
|
12,012 |
9,101 |
$1.13M |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
3,971 |
3,687 |
$842K |
| 93325 |
|
8,331 |
7,450 |
$796K |
| 82803 |
|
3,964 |
3,110 |
$755K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
7,070 |
6,349 |
$724K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,022 |
964 |
$698K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,462 |
2,225 |
$681K |
| 95782 |
|
1,147 |
1,080 |
$654K |
| 81025 |
|
4,497 |
3,972 |
$643K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,333 |
5,802 |
$543K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
3,466 |
3,167 |
$525K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
7,268 |
5,140 |
$513K |
| 71046 |
Radiologic examination, chest; 2 views |
8,408 |
7,551 |
$500K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,934 |
1,617 |
$463K |
| 76770 |
|
5,064 |
4,732 |
$377K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
7,803 |
5,818 |
$373K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
20,416 |
17,121 |
$351K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,775 |
3,328 |
$347K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
10,198 |
7,641 |
$347K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
3,023 |
2,804 |
$342K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
3,055 |
2,667 |
$321K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,439 |
3,903 |
$297K |
| 64642 |
|
963 |
909 |
$294K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,602 |
2,399 |
$279K |
| 93304 |
|
1,486 |
1,354 |
$278K |
| 96450 |
|
1,585 |
1,090 |
$276K |
| 81001 |
|
12,046 |
10,779 |
$276K |
| Q9958 |
High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml |
1,276 |
1,115 |
$275K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,937 |
5,351 |
$246K |
| 74230 |
|
1,931 |
1,840 |
$245K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
10,523 |
9,557 |
$236K |
| 80050 |
General health panel |
1,804 |
1,655 |
$228K |
| 74018 |
|
3,255 |
2,795 |
$221K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
2,513 |
2,253 |
$220K |
| J2704 |
Injection, propofol, 10 mg |
18,605 |
15,148 |
$219K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,677 |
1,529 |
$218K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,580 |
3,260 |
$211K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,120 |
2,818 |
$207K |
| 80053 |
Comprehensive metabolic panel |
24,816 |
18,696 |
$202K |
| 95819 |
|
1,023 |
917 |
$201K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,045 |
3,074 |
$199K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
5,163 |
3,414 |
$197K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
18,014 |
13,781 |
$171K |
| 64643 |
|
988 |
783 |
$166K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
2,077 |
1,956 |
$163K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
25,123 |
19,816 |
$161K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,323 |
1,446 |
$161K |
| 93308 |
|
2,255 |
1,978 |
$159K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,446 |
4,979 |
$156K |
| 93356 |
|
1,022 |
880 |
$156K |
| 95816 |
|
733 |
656 |
$144K |
| 72170 |
|
1,928 |
1,770 |
$144K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
8,329 |
6,754 |
$139K |
| C1769 |
Guide wire |
1,195 |
1,027 |
$136K |
| 90686 |
|
3,870 |
3,561 |
$133K |
| 74019 |
|
1,646 |
1,513 |
$126K |
| 93225 |
|
1,198 |
1,025 |
$125K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
1,596 |
1,494 |
$119K |
| 76885 |
|
1,599 |
1,416 |
$119K |
| 92523 |
|
861 |
837 |
$114K |
| J0475 |
Injection, baclofen, 10 mg |
807 |
714 |
$113K |
| 86850 |
|
2,119 |
1,517 |
$104K |
| 94060 |
|
678 |
625 |
$102K |
| 87070 |
|
2,410 |
2,181 |
$100K |
| 62369 |
|
223 |
206 |
$94K |
| 82330 |
|
2,023 |
1,807 |
$91K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,058 |
3,523 |
$87K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
970 |
913 |
$80K |
| 87631 |
|
1,336 |
1,218 |
$80K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
5,545 |
4,953 |
$79K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14,775 |
12,170 |
$77K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,627 |
4,246 |
$74K |
| 92526 |
|
1,671 |
1,354 |
$74K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
479 |
426 |
$74K |
| 85007 |
|
11,418 |
8,567 |
$68K |
| 80061 |
Lipid panel |
2,509 |
2,230 |
$68K |
| 77072 |
|
1,178 |
1,119 |
$68K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,249 |
2,949 |
$65K |
| 80069 |
|
3,256 |
2,539 |
$63K |
| 76376 |
|
1,229 |
1,118 |
$62K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,216 |
1,345 |
$62K |
| 76536 |
|
640 |
604 |
$60K |
| 87081 |
|
1,654 |
1,535 |
$56K |
| 72141 |
|
296 |
269 |
$55K |
| 94664 |
|
516 |
485 |
$55K |
| J0586 |
Injection, abobotulinumtoxina, 5 units |
1,392 |
1,178 |
$55K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,871 |
1,733 |
$54K |
| 76870 |
|
494 |
454 |
$53K |
| 89050 |
|
1,946 |
1,395 |
$52K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
5,684 |
4,746 |
$50K |
| 94010 |
|
874 |
821 |
$49K |
| 86364 |
|
667 |
624 |
$49K |
| 70360 |
|
654 |
604 |
$47K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
429 |
400 |
$46K |
| 87186 |
|
2,473 |
2,258 |
$43K |
| 73090 |
|
847 |
779 |
$42K |
| 72040 |
|
658 |
586 |
$40K |
| 96409 |
|
3,111 |
1,828 |
$39K |
| 83735 |
|
5,683 |
3,380 |
$39K |
| 71045 |
Radiologic examination, chest; single view |
1,097 |
975 |
$38K |
| 87799 |
|
1,696 |
762 |
$38K |
| 97162 |
|
424 |
414 |
$38K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,613 |
1,461 |
$38K |
| 82784 |
|
5,576 |
3,826 |
$36K |
| 73590 |
|
531 |
474 |
$36K |
| 84439 |
|
4,195 |
3,821 |
$36K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,863 |
4,444 |
$36K |
| 87507 |
|
338 |
325 |
$34K |
| 86901 |
|
2,208 |
1,575 |
$33K |
| 76825 |
|
141 |
125 |
$32K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,677 |
1,515 |
$31K |
| 93320 |
|
3,482 |
3,176 |
$31K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
3,071 |
2,803 |
$28K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
486 |
456 |
$28K |
| 67311 |
|
390 |
363 |
$26K |
| 80076 |
|
797 |
723 |
$26K |
| 93321 |
|
3,801 |
3,381 |
$25K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
33 |
27 |
$25K |
| 92567 |
|
1,187 |
1,139 |
$24K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
591 |
455 |
$23K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,269 |
1,860 |
$23K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,532 |
2,278 |
$22K |
| 70486 |
|
269 |
255 |
$22K |
| 80197 |
|
3,736 |
1,919 |
$22K |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
763 |
649 |
$22K |
| 95812 |
|
120 |
110 |
$21K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
72 |
67 |
$21K |
| 73080 |
|
179 |
169 |
$21K |
| 36430 |
|
917 |
567 |
$21K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,539 |
2,223 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,292 |
3,940 |
$19K |
| 73630 |
|
357 |
327 |
$19K |
| 95951 |
|
40 |
39 |
$19K |
| 82610 |
|
790 |
683 |
$18K |
| 86003 |
|
987 |
473 |
$18K |
| 83970 |
|
751 |
675 |
$18K |
| 72082 |
|
199 |
194 |
$18K |
| 96415 |
|
402 |
307 |
$18K |
| 92610 |
|
428 |
399 |
$17K |
| 93226 |
|
814 |
763 |
$17K |
| 86140 |
|
8,953 |
7,740 |
$16K |
| 82785 |
|
541 |
500 |
$16K |
| 86900 |
|
2,231 |
1,583 |
$16K |
| 82397 |
|
875 |
817 |
$16K |
| 85651 |
|
6,265 |
5,557 |
$16K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
238 |
219 |
$15K |
| 82570 |
|
2,148 |
1,859 |
$15K |
| 81003 |
|
1,772 |
1,635 |
$14K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,912 |
1,290 |
$14K |
| 74455 |
|
1,016 |
958 |
$14K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,101 |
924 |
$13K |
| J9370 |
Vincristine sulfate, 1 mg |
2,477 |
1,580 |
$13K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
204 |
190 |
$13K |
| 42830 |
|
103 |
96 |
$13K |
| 73610 |
|
331 |
293 |
$12K |
| 83516 |
|
2,449 |
2,283 |
$12K |
| 82977 |
|
3,078 |
2,491 |
$12K |
| 84100 |
|
4,212 |
2,760 |
$12K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
429 |
398 |
$12K |
| 72100 |
|
148 |
124 |
$12K |
| 54161 |
|
850 |
769 |
$12K |
| J3490 |
Unclassified drugs |
426 |
345 |
$12K |
| 92018 |
|
152 |
128 |
$12K |
| 76827 |
|
141 |
125 |
$11K |
| 82728 |
|
2,764 |
2,326 |
$11K |
| 95700 |
|
48 |
44 |
$11K |
| 82248 |
|
1,006 |
813 |
$10K |
| 84403 |
|
351 |
323 |
$10K |
| 85610 |
|
2,726 |
2,276 |
$10K |
| 51600 |
|
1,023 |
966 |
$10K |
| 0100U |
|
235 |
195 |
$10K |
| 73140 |
|
90 |
83 |
$10K |
| S5000 |
Prescription drug, generic |
13 |
13 |
$9K |
| 87040 |
|
2,008 |
1,768 |
$9K |
| 86356 |
|
85 |
37 |
$9K |
| 12011 |
|
485 |
453 |
$9K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
722 |
561 |
$8K |
| 20680 |
|
36 |
24 |
$8K |
| 84466 |
|
1,810 |
1,654 |
$8K |
| 83615 |
|
1,595 |
1,207 |
$8K |
| 83690 |
|
1,862 |
1,662 |
$7K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
89 |
78 |
$7K |
| 92587 |
|
320 |
305 |
$7K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
366 |
327 |
$7K |
| 81229 |
|
12 |
12 |
$7K |
| 97166 |
|
103 |
101 |
$7K |
| 87147 |
|
939 |
857 |
$7K |
| 83880 |
|
489 |
383 |
$6K |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
61 |
39 |
$6K |
| 73130 |
|
93 |
84 |
$6K |
| 51728 |
|
134 |
126 |
$6K |
| 86923 |
|
558 |
258 |
$6K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
61 |
52 |
$6K |
| 97802 |
|
161 |
146 |
$6K |
| 70250 |
|
65 |
56 |
$6K |
| 87077 |
|
561 |
502 |
$6K |
| 96411 |
|
773 |
418 |
$6K |
| 82043 |
|
969 |
863 |
$6K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
48 |
38 |
$6K |
| 86832 |
|
49 |
38 |
$6K |
| 82550 |
|
1,255 |
1,066 |
$6K |
| J9250 |
Methotrexate sodium, 5 mg |
1,742 |
1,089 |
$6K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
1,565 |
1,405 |
$6K |
| 51797 |
|
117 |
110 |
$5K |
| 51784 |
|
98 |
93 |
$5K |
| 83540 |
|
1,926 |
1,756 |
$5K |
| 73110 |
|
69 |
64 |
$5K |
| 93296 |
|
141 |
131 |
$5K |
| 72070 |
|
151 |
125 |
$5K |
| 69209 |
|
94 |
84 |
$5K |
| 83002 |
|
335 |
298 |
$5K |
| P9040 |
Red blood cells, leukocytes reduced, irradiated, each unit |
51 |
41 |
$5K |
| 73552 |
|
79 |
65 |
$5K |
| 74220 |
|
14 |
13 |
$5K |
| 97803 |
|
203 |
186 |
$5K |
| 72146 |
|
98 |
91 |
$4K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
332 |
257 |
$4K |
| 92555 |
|
131 |
124 |
$4K |
| 74240 |
|
27 |
26 |
$4K |
| 87088 |
|
584 |
536 |
$4K |
| 88304 |
|
449 |
400 |
$4K |
| 84156 |
|
879 |
719 |
$4K |
| 84145 |
|
522 |
466 |
$4K |
| 84550 |
|
898 |
658 |
$3K |
| 84484 |
|
68 |
60 |
$3K |
| 70480 |
|
13 |
13 |
$3K |
| 85730 |
|
1,312 |
1,100 |
$3K |
| 76506 |
|
30 |
26 |
$3K |
| 86833 |
|
47 |
37 |
$3K |
| 87497 |
|
615 |
269 |
$3K |
| 76377 |
|
72 |
72 |
$3K |
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
753 |
420 |
$3K |
| 93975 |
|
29 |
28 |
$3K |
| J3480 |
Injection, potassium chloride, per 2 meq |
1,498 |
1,208 |
$3K |
| 73562 |
|
41 |
38 |
$3K |
| 54640 |
|
44 |
41 |
$3K |
| 82810 |
|
316 |
177 |
$3K |
| 76882 |
|
62 |
55 |
$3K |
| 84305 |
|
421 |
387 |
$3K |
| 88185 |
|
67 |
54 |
$3K |
| 43760 |
|
13 |
12 |
$3K |
| 84630 |
|
352 |
323 |
$3K |
| T1015 |
Clinic visit/encounter, all-inclusive |
295 |
207 |
$3K |
| 83605 |
|
68 |
63 |
$3K |
| V5264 |
Ear mold/insert, not disposable, any type |
335 |
315 |
$3K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
26 |
25 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
184 |
102 |
$2K |
| 82247 |
|
76 |
50 |
$2K |
| 76981 |
|
12 |
12 |
$2K |
| 87184 |
|
1,194 |
1,090 |
$2K |
| 82805 |
|
31 |
26 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
188 |
164 |
$2K |
| 31622 |
|
24 |
24 |
$2K |
| 88342 |
|
211 |
177 |
$2K |
| 82105 |
|
108 |
100 |
$2K |
| 86038 |
|
356 |
333 |
$2K |
| 91200 |
|
15 |
13 |
$2K |
| 86480 |
|
124 |
115 |
$2K |
| 77076 |
|
14 |
12 |
$2K |
| 85379 |
|
176 |
130 |
$2K |
| 86039 |
|
18 |
14 |
$2K |
| 82139 |
|
112 |
104 |
$2K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
146 |
125 |
$2K |
| 12001 |
|
92 |
81 |
$2K |
| 86160 |
|
463 |
404 |
$2K |
| 73060 |
|
12 |
12 |
$2K |
| 0071A |
|
67 |
62 |
$2K |
| 86803 |
|
296 |
251 |
$1K |
| 78708 |
|
12 |
12 |
$1K |
| 84703 |
|
27 |
25 |
$1K |
| 83520 |
|
134 |
115 |
$1K |
| 97161 |
|
13 |
12 |
$1K |
| 49452 |
|
120 |
112 |
$1K |
| 86359 |
|
157 |
136 |
$1K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
357 |
288 |
$1K |
| 83655 |
|
107 |
90 |
$1K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
108 |
93 |
$1K |
| 72197 |
|
14 |
13 |
$1K |
| 97116 |
|
125 |
97 |
$1K |
| 88307 |
|
91 |
76 |
$1K |
| 82017 |
|
15 |
14 |
$983.43 |
| 80164 |
|
79 |
68 |
$965.05 |
| 83001 |
|
231 |
206 |
$943.93 |
| 96367 |
|
231 |
169 |
$932.88 |
| 71250 |
|
14 |
13 |
$929.60 |
| 88240 |
|
82 |
65 |
$919.37 |
| 99001 |
|
31 |
30 |
$918.83 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
62 |
38 |
$846.87 |
| 85046 |
|
1,883 |
1,590 |
$827.97 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
218 |
212 |
$784.76 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
188 |
164 |
$760.97 |
| 88313 |
|
69 |
49 |
$725.28 |
| 31720 |
|
14 |
12 |
$723.63 |
| 96376 |
|
20 |
12 |
$649.28 |
| 86706 |
|
171 |
151 |
$596.38 |
| 92579 |
|
73 |
72 |
$578.11 |
| 70355 |
|
39 |
38 |
$572.32 |
| 36415 |
Collection of venous blood by venipuncture |
288 |
224 |
$528.43 |
| 86665 |
|
83 |
77 |
$514.29 |
| V5266 |
Battery for use in hearing device |
466 |
445 |
$510.77 |
| 0072A |
|
17 |
17 |
$490.62 |
| 90656 |
|
92 |
92 |
$477.20 |
| 84590 |
|
65 |
56 |
$464.11 |
| 92552 |
|
12 |
12 |
$453.18 |
| 93976 |
|
47 |
44 |
$441.94 |
| J1644 |
Injection, heparin sodium, per 1000 units |
285 |
214 |
$406.99 |
| 82379 |
|
62 |
60 |
$375.16 |
| 92556 |
|
12 |
12 |
$348.16 |
| 0004A |
|
14 |
14 |
$339.66 |
| 86376 |
|
332 |
308 |
$293.43 |
| 88184 |
|
68 |
55 |
$274.90 |
| 97124 |
|
414 |
324 |
$246.37 |
| 87496 |
|
30 |
25 |
$233.68 |
| 94726 |
|
13 |
12 |
$216.54 |
| 86360 |
|
14 |
13 |
$208.84 |
| 87340 |
|
324 |
283 |
$203.81 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
34 |
25 |
$195.00 |
| 84446 |
|
55 |
46 |
$189.10 |
| 86225 |
|
63 |
57 |
$183.24 |
| 73120 |
|
15 |
12 |
$175.40 |
| 86355 |
|
132 |
102 |
$167.68 |
| 85246 |
|
44 |
38 |
$137.96 |
| 87116 |
|
17 |
16 |
$84.07 |
| 73560 |
|
15 |
12 |
$76.28 |
| 98960 |
|
13 |
13 |
$73.44 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
14 |
12 |
$64.80 |
| 84460 |
|
82 |
79 |
$61.39 |
| 86431 |
|
43 |
38 |
$55.58 |
| 82085 |
|
17 |
15 |
$43.16 |
| 88311 |
|
43 |
38 |
$37.84 |
| 84295 |
|
18 |
14 |
$26.75 |
| 86790 |
|
29 |
24 |
$23.62 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
85 |
66 |
$22.40 |
| 82657 |
|
23 |
12 |
$20.06 |
| 86800 |
|
27 |
27 |
$19.64 |
| 84146 |
|
14 |
12 |
$11.31 |
| 82150 |
|
20 |
15 |
$7.20 |
| 86592 |
|
17 |
12 |
$4.74 |
| Q5104 |
Injection, infliximab-abda, biosimilar, (renflexis), 10 mg |
133 |
123 |
$0.00 |
| 95990 |
|
59 |
53 |
$0.00 |
| V5008 |
Hearing screening |
41 |
39 |
$0.00 |
| 95715 |
|
13 |
13 |
$0.00 |
| 31526 |
|
16 |
13 |
$0.00 |
| G0378 |
Hospital observation service, per hour |
79 |
57 |
$0.00 |
| 82670 |
|
42 |
40 |
$0.00 |
| 82607 |
|
16 |
12 |
$0.00 |
| 86704 |
|
16 |
12 |
$0.00 |
| 86357 |
|
13 |
12 |
$0.00 |
| 25605 |
|
15 |
13 |
$0.00 |
| 24538 |
|
31 |
29 |
$0.00 |
| 29125 |
|
14 |
14 |
$0.00 |
| 92611 |
|
94 |
93 |
$0.00 |
| 85384 |
|
23 |
15 |
$0.00 |
| A9562 |
Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries |
12 |
12 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
32 |
25 |
$0.00 |
| 88302 |
|
24 |
20 |
$0.00 |
| 29105 |
|
12 |
12 |
$0.00 |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
15 |
13 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
13 |
12 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
14 |
13 |
$0.00 |